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All your pregnancy questions answered

What is the 'normal' position of the baby for delivery?

In the great majority of cases the baby lies with its head down and the buttocks up. This is called a cephalic [head] presentation, and is the most likely to lead to a normal vaginal delivery. In this cephalic presentation there are various variations too:

• Vertex-when the chin is touching the chest and the head is well bent

• Military-this is a 'de flexed' vertex where the face is looking straight and this presents a larger diameter for the delivery

• Brow-where the head is looking up and the brow [forehead] is the leading part for the delivery. This is discussed further and it is not possible to have a vaginal delivery with this position

• Face-when the head is completely 'extended' as in a person looking to the sky.

In the vertex positions further you can have 2 variations:

• Occipito anterior-when the back of the head is pointing towards the front of the mother as in the baby is looking, with the nose pointing backwards

• Occipito posterior-when the back of the head is pointing towards the back of the mother as in the baby is looking, with the nose pointing forwards

The most common as well as the most favourable for a normal delivery is the LOA [Left Occipito Anterior position]

Cephalic Presentation

Breech presentation

A breech presentation is said to occur when your baby lies 'upside down' ie; the head of the baby is upwards and the buttocks are downwards. If this is your first pregnancy you will usually be asked to undergo a planned caesarian section. If this is your second or third pregnancy with a previous vaginal delivery you may be allowed to try for a normal delivery.

Breech Presentation

Transverse lie

If you have a transverse lie your baby is lying across your stomach with the head on one side and the buttocks on the other. Neither the head nor the buttocks are over the birth canal and it is impossible for you to have a normal delivery

Brow presentation

Is when the head is down but the neck of the baby is extended and again the diameter of the head becomes too large to allow a normal delivery

Cord presentation

If your babies umbilical cord overlies the mouth of the uterus this is called a cord presentation and is extremely dangerous as when your bag of waters ruptures the cord comes out first and prevents the baby from getting its oxygen supply from your uterus.

Occipito posterior positions

This is when your baby is head down [as a normal 'cephalic' presentation] but the back of the head [occiput] is towards your back instead of towards your front as it should be. This means that the nose of your baby is pointing forwards instead of backwards as it should be. This is seen in about 30% of patients and may lead to longer and more painful labours with a higher chance of a caesarian section.